Related Experiment Video
Updated: Oct 4, 2025

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
Published on: September 13, 2020
Recurrent Pneumothorax Following First Rib Resection and Anterior Scalenectomy
Mary Katherine Adkins1, Lydia Faber1, Julie Freischlag1
112280Wake Forest Baptist Medical Center, Winston Salem, NC 27157, USA.
Abstract:
In this report, we describe a 35-year-old female with neurogenic thoracic outlet syndrome (NTOS) who presented with a post-pull pneumothorax following first rib resection and anterior scalenectomy (FRRAS). During the FRRAS, a large amount of scar tissue was observed surrounding the first rib, resulting in a tear in the pleura as the rib was resected. This created a pneumothorax which required chest tube placement and observation overnight. The patient was discharged 1 day post-operatively, feeling well but was then re-admitted 2 days later due to the presence of a recurrent pneumothorax. A chest tube was placed again, and the patient was monitored until symptom resolution. The occurrence of a post-pull pneumothorax has never been reported following FRRAS in TOS patients. The patient's symptoms have improved 4 months post operation.
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